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Nerve-Severing Surgery Curbs Excessive Sweating: Study

Minimally invasive procedure cut signals to glands for sufferers of hyperhidrosis

TUESDAY, April 17, 2007 (HealthDay News) -- Surgery to sever the nerves that send signals to the sweat glands in the skin can help treat people who suffer from excessive sweating, called hyperhidrosis, according to new research.

People with hyperhidrosis, which affects about three percent of the world's population, or almost 197 million people, sweat three to four times the normal amount. Four areas are typically affected: the palms, the underarms, the face, and the feet.

The exact cause is not known, but it has been linked to over-activity of the nerves that send signals to the sweat glands in the skin, according to background information in the article. Treatments have included topical and oral medication, Botox injections, and iontophoresis. Surgery may be an option when these treatments prove ineffective.

This study, conducted by a team at the Barrow Neurological Institute in Phoenix, looked at the outcomes of 300 hyperhidrosis patients who had bilateral thoracoscopic sympathectomy surgery. In this minimally invasive procedure, a tiny fiber optic camera and surgical instruments are inserted through three small incisions. The surgeons identify and cut the nerves that cause the excessive sweating.

The patients in the study included 129 with excessive palm sweating, 11 with underarm sweating, and 160 with both palm and underarm sweating.

The surgery stopped palm hyperhidrosis in 99.3 percent of patients and underarm hyperhidrosis in 61 percent. Complications included: two cases of arrhythmia (irregular heartbeat); one case of postoperative depression; nine cases of postoperative pneumothorax (accumulation of air in the pleural cavity), of which five required chest tube drainage; and four cases of patients who required prophylactic chest tube drainage due to pleural adhesions.

The study also said that 16 patients experienced compensatory hyperhidrosis, where excessive sweating begins in other areas of the body, such as the chest, back or legs. Seven patients suffered Horner's syndrome, which results from inadvertent damage to nerves above those that were cut. This can lead to decreased facial sweating, eyelid drooping, and decreased pupil size on the side of the body with the nerve damage.

Six patients experienced intercostal neuralgia -- pain caused by damage to the nerves located between the ribs.

The study was to be presented Tuesday at the annual meeting of the American Association of Neurological Surgeons, in Washington, D.C.

More information

The U.S. National Library of Medicine has more about hyperhidrosis.

SOURCE: American Association of Neurological Surgeons, news release, April 16, 2007
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